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Building Engagement Using Financial Incentives for Colorectal Cancer Screening (BENEFIT-C) in a Rural Louisiana Federally Qualified Health Center

Health Serv Res. 2026 Apr;61(2):e70011. doi: 10.1111/1475-6773.70011. Epub 2025 Jul 22.

ABSTRACT

OBJECTIVE: To evaluate the preliminary effectiveness and feasibility of a community-engaged financial incentive intervention for increasing colorectal cancer (CRC) screening in a rural, low-resource primary care setting.

STUDY SETTING AND DESIGN: A feasibility pilot trial at a federally qualified health center in the Acadiana region, Louisiana. Participants were identified via electronic health records (EHR), recruited by telephone, and randomized to intervention (n = 25) or control (n = 25). Both groups received incentives for flu and COVID-19 vaccines. The intervention group also received incentives for CRC screening. Fisher’s Exact tests evaluated between-group differences in completion of CRC screening (primary outcome), flu, and COVID-19 vaccines 2 months post-enrollment.

DATA SOURCES AND ANALYTIC SAMPLE: Eligible patients were aged 45-75, due for CRC screening, and English-speaking. From November 11, 2023 to March 31, 2024, completion of each outcome was obtained from the EHR.

PRINCIPAL FINDINGS: 57% of interested individuals were eligible; 94% of eligible individuals enrolled. Participants were 70% female, 42% Black, 24% uninsured, with a mean age of 52.4 years. Completion of CRC screening was higher in the intervention versus control group (17 [68%] vs. 8 [32%], p = 0.02).

CONCLUSION: Financial incentives significantly increased completion of CRC screening. Future research should confirm findings in larger samples and evaluate cost-effectiveness to inform health system policies.

PMID:42853034 | DOI:10.1111/1475-6773.70011